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Plans for NICE to overhaul quality framework indicators could end the UK-wide GMS contract, GPs fear.

Last week, health minister Lord Ara Darzi told the House of Commons health select committee that NICE, rather than the expert review panel, would identify priorities for the framework.

Cost-effectiveness and impact on the 'health of the nation' would be the deciding factors, with interventions scoring high on both most likely to be included, he told MPs.

The shake-up is likely to see some current indicators dropped, Lord Darzi told MPs.

'I can't believe it's going to be extra points in the QOF,' he said.

NICE deputy chief executive Gillian Leng said the organisation would oversee 'an independent and transparent process for developing and reviewing the indicators'.

NICE will also be 'discussing with the BMA and others how to increase the quality framework's focus on health promotion, clinical quality and health outcomes', she added.

But GPC deputy chairman Dr Richard Vautrey told GP: 'All we've seen is the suggestions in the Darzi proposals. We've not had any other indications or correspondence.'

He added: 'NICE only covers England and Wales and the quality framework is a four-nation entity.

'We are keen to preserve a UK-wide contract.'

The Scottish Intercollegiate Guidelines Network (SIGN) currently issues clinical guidelines for Scotland.

A spokesman said: 'If the framework is to change, we'd expect SIGN and NICE advice to be included. SIGN guidelines have formal status in Scotland, NICE guidelines don't.'

A spokeswoman for BMA Scotland said: 'England-only bodies can't make decisions for the whole of the UK.'

Although Lord Darzi is determined to boost the QOF's focus on preventive care, hinting at more targets on obesity and alcohol abuse, Dr Vautrey warned: 'It's not a public health tool.'

NAPC chairman Dr James Kingsland said that NICE was seen as focusing too much on cost, rather than cost-effectiveness.

rachel.liddle@haymarket.com

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